Introduction
Metoclopramide is a D2 receptor antagonist mainly used in the management of nausea.
Indications
The main use is in the management of nausea and vomiting. Other uses include:
- Gastro-oesophageal reflux disease
- Prokinetic action is useful in gastroparesis secondary to diabetic neuropathy
- Often combined with analgesics for the treatment of migraine (migraine attacks result in gastroparesis, slowing the absorption of analgesics)
Adverse effects
- Extrapyramidal effects: oculogyric crisis. This is particularly a problem in children and young adults
- Hyperprolactinaemia
- Tardive dyskinesia
- Parkinsonism
Contraindications
Metoclopramide should be avoided in bowel obstruction, but may be helpful in paralytic ileus.